ECM Mentor Information Form

To apply to be in our database of mentors to be matched, please provide the following information.

Personal Information

Last name

This is a required question

First name

This is a required question

E-mail

This is a required question

Work phone number (optional)

This is a required question

Place of Employment and Location

This is a required question

Current Position

This is a required question

Mentor Matching Information

MAA Section

This is a required question

Highest Degree Earned

PhD

Masters

This is a required question

Which field best describes your degree/area of work?

Pure Mathematics

Applied Mathematics

Math Ed

Statistics

Other:

This is a required question

Which best describes places you have held positions?

Check all that apply

Research Institution

Liberal Arts College

Community College

Industry/Government

Other:

This is a required question

What are your current professional interests, both in mathematics and in other professional areas (such as teaching or professional service)?

This is a required question

Do you have any preferences for matching you with a mentee? For example, graduate student near completion, post-doc, new non-tenure track faculty member, new tenure track faculty member, non-academic, others?

This is a required question

Do you have any other preferences for matching you with a mentee? For example, if you would like to be matched with someone from a particular gender or ethnic group, or with someone from a particular type of institution, please let us know.

This is a required question

If you feel comfortable providing demographic information such as race, ethnicity, gender, first generation college or academia, etc. we will be happy to know this, but this is completely optional, of course.